B. Overview of VA Cost Methods

5. How can I compare medical/surgical stays in the VA to non-VA stays (e.g., Medicare)?

Although it may be tempting to compare VA discharge records from the PTF Main file or the DSS Discharge file to non-VA inpatient data, such as the Medicare or HCUP, you would be comparing apples and oranges. The reason is quite simple: VA and commercial hospitals define a hospital discharge differently.

Consider Joe, an older veteran, who is admitted into a medical bedsection/treating specialty with a broken hip. During the stay, Joe gets surgery, spends a few days in the ICU, recovers some more in medicine and then spends some time in the nursing home before Joe is discharged to home. If Joe received this care in the VA, all of the care is included in a single discharge record. But if Joe was admitted to a commercial hospital instead, he would not be transferred from medicine to nursing home. Rather Joe would be discharged from the medical surgical hospital. Joe’s care in a nursing home would be captured in a separate discharge record. Commercial hospitals would have two discharge records for Joe, whereas the VA captured this information in one record.

If you want to compare VA discharges to non-VA discharges, you will need to reorganize the VA data. We have developed a SAS program for this-- see [FAQ I-16 ]